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Calcifications on Mammogram Do Not Correlate with Tumor Size After Neoadjuvant Chemotherapy

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Calcifications can be indicative of malignancy, but calcifications also can be a byproduct of necrotic tissue as cancer cells die. Current treatment regimens require excision of calcifications. The objective of this study was to examine the correlation between the extent of calcification on mammography and actual tumor size after neoadjuvant chemotherapy (NAC) as well as magnetic resonance imaging (MRI) for comparison.

Methods

We retrospectively reviewed all patients at the University of California, San Diego, who underwent NAC for breast cancer between 2007 and 2013. Pearson correlation coefficients were computed between breast imaging and pathological measurements.

Results

There were 136 patients total. Average age was 51 years. Fifty-three patients had calcifications on imaging (calc+); 83 did not (calc−). In the calc− group, extent of disease measured by mammogram (MMG) and MRI correlated moderately well with pathological tumor size (0.46 and 0.48, p = not significant). In the calc+ group, MRI was more likely to correlate with pathology than MMG (0.55 vs. −0.12, p = 0.01). Twenty-five calc+ patients had increased calcification after NAC; six of these had complete pathologic response. MRI correlated better with tumor size on pathology in patients with anti-HER2neu-based regimens than in patients with cytotoxic chemotherapy-alone regimens (0.88 vs. 0.4, p = 0.0001). MRI also is more accurate at predicting pathological tumor size in patients with triple negative disease (p = 0.002).

Conclusions

Magnetic resonance imaging correlated well while MMG calcification measurements correlated poorly with tumor size on final pathology. Extent of calcifications on diagnostic mammography may not be accurate in preoperative evaluation of breast cancers after NAC.

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Authors and Affiliations

  1. Department of Surgery, University of California, San Diego, La Jolla, CA, USA

    Anna Weiss MD, Katherine C. Lee BS, Yajahira Romero, Erin Ward MD & Sarah L. Blair MD, FACS

  2. Department of Radiology, Inha University School of Medicine, Incheon, South Korea

    Yeunjeong Kim MD

  3. Department of Radiology, University of California, San Diego, La Jolla, CA, USA

    Haydee Ojeda-Fournier MD

  4. Department of Radiation Oncology, University of California, San Diego, La Jolla, CA, USA

    John Einck MD

Authors
  1. Anna Weiss MD
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  2. Katherine C. Lee BS
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Corresponding author

Correspondence to Sarah L. Blair MD, FACS.

Additional information

Accepted for presentation at ASBS, Las Vegas NV, May 2, 2014.

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Weiss, A., Lee, K.C., Romero, Y. et al. Calcifications on Mammogram Do Not Correlate with Tumor Size After Neoadjuvant Chemotherapy. Ann Surg Oncol 21, 3310–3316 (2014). https://doi.org/10.1245/s10434-014-3914-0

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  • DOI: https://doi.org/10.1245/s10434-014-3914-0

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